Question 1

CALCULATOR

Which one of the following statements is true of transpiration?

● A. With higher humidity rate increases

● B. With greater wind speed rate decreases

● C. With greater light intensity rate increases

● D. With lower temperatures rate increases

Difficulty: EASY
C

Explanation‾Explanation:
Transpiration is the loss of water vapour from a plant via the stomata. At high light intensity, more stomata are likely to be open to
allow more carbon dioxide to diffuse into the leaf for photosynthesis, while at the same time resulting in more loss of water from the
plant via transpiration. Choice C is correct.

Higher humidity means there is more moisture in the air, meaning there is a smaller difference in water concentration between the
inside of the leaf and the surrounding air, so diffusion of water molecules out of the stomata decreases. Choice A is incorrect. As
wind speeds increase, more of the humid air around the leaves is blown away and replaced by drier air, therefore increasing the
water concentration gradient between the inside of the leaf and the surrounding air, increasing the rate of diffusion of water
molecules out of the stomata. Choice B is incorrect.

At lower temperatures, molecules have lower kinetic energy, so the rate of diffusion of water molecules out of the stomata will
decrease. Also at lower temperatures plants tend to have fewer stomata open. Choice D is incorrect.

Question 2
CALCULATOR

The graph shows a spirometer trace of a student who took part in a breathing experiment. Which part of the trace represents the
volume of air breathed in and out during normal, relaxed breathing?

[©Revision Village 2023]

Difficulty: EASY
C

Explanation‾Explanation:
Choice C is correct because the tidal volume is the volume of air breathed in or out during normal, relaxed breathing, which can be
seen as the central wave that is constant throughout the graph, representing normal breathing at rest.

Choice A is incorrect because this is the inspiratory reserve volume which represents the difference between the maximum
inspiratory level and the tidal volume. Choice B is incorrect because this is the vital capacity is the maximum volume of air that can
be forcefully exhaled after maximal inhalation. Choice D is incorrect because this is the expiratory reserve volume which represents
the difference between the maximum expiratory level and the tidal volume.

Question 3
CALCULATOR

Which of the following substances typically moves either in or out of a leaf's inner air space via stomata?

● I. Water
● II. Oxygen
● III. Mineral ions
● A. I only

● B. III only

● C. I and II

● D. I, II and III

Difficulty: EASY
C

Explanation‾Explanation:
Water diffuses out of stomata from the inner air space of leaves during transpiration (Option I). Because oxygen is produced
during photosynthesis, its concentration is generally higher in the inner air space than the atmosphere which means it diffuses out
through the stomata (Option II). Mineral ions (Option III) enter plants through root cells, not through the stomata.

Question 4
CALCULATOR

The diagram below shows a potometer which is used to measure water uptake in plants.

[Source: Knott, T. (2006, August). File: Potometer.png. Wikimedia commons. Retrieved June 20, 2022, from https
://commons.wikimedia.org/wiki/File: Potometer.png. CC-BY-SA-3.0-migrated]

A plant cutting was placed in the potometer as shown above. What changes would be observed after a few hours?

● A. The water in the reservoir will increase.

● B. The bubble will move right towards the direction of the beaker.

● C. The bubble will move left towards the direction of the plant.
 ● D. The water level in the beaker will rise.

Difficulty: EASY
C

Explanation‾Explanation:
A potometer is used to measure the rate of transpiration in a plant. When transpiration takes place, water loss occurs because
water evaporates inside the leaves and then diffuses out of the leaves. The bubble in the capillary tube will move in the direction of
the plant along with the water in the capillary tube which is being absorbed by the plant (Choice C).

Choice B is incorrect because the water and bubble are moving towards the plant, not away from it.

Choice A is incorrect because the water in the reservoir will stay at the same level. The reservoir contains a switch that is used to
refill the capillary tube and push the bubble back to the start position. This is done at the end of the experiment to reset the
apparatus for the next measurement.

Choice D is incorrect as the water level in the beaker will decrease as water enters the capillary tube and also because of
evaporation from the beaker to the atmosphere.

Question 5
CALCULATOR

How is the concentration gradient of water maintained in the leaf?

I. Stomata opens to allow water vapour to escape.

II. Air spaces in the spongy mesophyll allow water from the mesophyll cells to evaporate.

III. Waxy cuticle layer of the upper epidermis reduces the amount of water escaping the leaf.

● A. I only

● B. III only

● C. I and II only

● D. I, II and III

Difficulty: EASY
D

Explanation‾Explanation:
Choice D is correct because the waxy cuticle layer of the upper epidermis reduces water loss through evaporation from the leaf
(Statement III). The stomata found in the lower epidermis of the leaf would open to allow water vapour to escape during
transpiration (Statement I). Water from the thin film of moisture surrounding the mesophyll cells can evaporate to form water vapour
that will fill up the air spaces around the loosely packed spongy mesophyll cells (Statement II).

Choice A is incorrect because it is missing statements II and III.

Choice B is incorrect because it is missing statements I and II.
Choice C is incorrect because it is missing statement III.
Question 6
CALCULATOR

[Maximum mark: 10]

The micrograph below shows a transverse section through the leaf of a monocot (Lilium sp.).
[Source: Science and Plants for Schools, (2012, May 1). Leaf of a monocot (Lilium sp.). Flickr. Retrieved October 11, 2023, from
https://www.flickr.com/photos/71183136@N08/6985212944. CC BY-NC-SA 2.0 DEED]

1. State the name and role of each of the structures P and Q. [2]

2. Explain how the presence and absence of water affects the structure labelled Q. [3]

3. Structure R represents the vascular bundle. Outline the role of these tissues in transpiration. [2]

4. Structure S consists of cells that are loosely packed together. Suggest a benefit to the leaf of having loosely packed cells.
[1]

5. State how the lower epidermis of Lilium sp. is structurally adapted for gas exchange. [1]

6. Suggest which part of this leaf would contain the most chloroplasts. [1]

Difficulty: EASY
Question 7
CALCULATOR

How do different muscles contribute to the decrease in air pressure inside the lungs, causing inhalation?

● A. Muscles on the abdominal wall contract

● B. Diaphragm relaxes

● C. External intercostal muscles shorten

● D. Internal intercostal muscles shorten

Difficulty: EASY
C

Explanation‾Explanation:
The process of air entering the lungs is known as inhalation. The term ““inspiration”” is used instead of inhalation sometimes. In
order for inhalation to take place, the pressure inside the lungs must be lower compared to atmospheric pressure. To decrease the
pressure inside the lungs, the external intercostal muscles must contract and become shorter to pull the ribs up and out, increasing
the volume inside the thorax, and so increasing lung volume.

Choice A is incorrect because abdominal wall muscles relax during inhalation. Lengthening of the abdominal muscles can
contribute to inhalation by pushing the abdominal wall out which increases the volume inside the thorax, and so too the volume of
the lungs.

Choice B is incorrect because when the diaphragm relaxes it forms a dome shape and therefore reduces the volume of the thorax,
and so the volume of the lungs. This occurs during exhalation.

Choice D is incorrect because internal intercostal muscles relax and lengthen during inhalation. They contract and shorten during
exhalation.

Question 8
CALCULATOR

Which leaf structure adaptation is correctly matched to its function?

 Adaptations Function

A. Waxy cuticle Contains many pores to facilitate gas exchange

B. Spongy mesophyll Creates a large impermeable barrier to prevent loss of gases and water vapour
from the surface

C. Stomatal guard cells Controls gas exchange and water loss by opening and closing

D. Lower epidermis Gives a large surface area for gas exchange

Difficulty: EASY
C

Explanation‾Explanation:
Choice C is correct because stomatal guard cells are found mostly at the lower epidermis, which controls gas exchange and water
loss by opening and closing the stomata.

Choice A is incorrect because the waxy cuticle creates a large impermeable barrier to prevent gases and water vapour loss from
the surface. Choice B is incorrect because spongy mesophyll provides a large surface area for gas exchange. Choice D is
incorrect because the lower epidermis contains many stomata to facilitate gas exchange.

Question 9
CALCULATOR

Which of the following takes place during exhalation?

● I. The diaphragm forms a dome shape

● II. Internal intercostal muscles contract
● III. Pressure increases inside the lungs
● A. I only

● B. II only

● C. I and III only

● D. I, II and III

Difficulty: EASY
D

Explanation‾Explanation:
During exhalation, the diaphragm relaxes and lifts upwards to form a dome shape (Statement I). The internal intercostal muscles
contract and pull the ribcage inwards and downwards (Statement II).

This causes the volume inside the thorax to decrease, which decreases the volume of the lungs, and so increases the pressure
inside the lungs (Statement III). Thus the air is forced out of the lungs.

Question 10
CALCULATOR

The alveoli are the site of gas exchange in the lungs. Which is not a way that the concentration gradient of oxygen is maintained
across the alveoli?

● A. A dense network of capillaries surrounding the alveoli

● B. Thin-walled alveoli

● C. Continuous blood flow

● D. Ventilation from the air

Difficulty: EASY
B

Explanation‾Explanation:
Alveoli have thin walls, which provide a short diffusion distance, so increases the rate of diffusion but does not directly maintain the
concentration gradient; Choice B is correct.

A dense network of capillaries with a continuous blood flow allows oxygenated blood to be quickly transported away from the lungs
towards the heart, therefore maintaining a lower concentration of oxygen in the capillaries surrounding the alveoli compared to the
alveoli themselves. Choice A and C are both true ways of maintaining the oxygen concentration gradient and so are incorrect
answers to the question. Ventilation from the air means that there is a steady and continuous supply of oxygen from the air into the
lungs, maintaining a higher concentration of oxygen in the lungs (alveoli) compared to the capillaries surrounding the alveoli.
Choice D is a true way of maintaining the oxygen concentration gradient and so is an incorrect answer to the question.

Question 11
CALCULATOR

Air is carried to the lungs by entering through the nostrils into the nasal cavity, and then as shown in the pathway below.

Which of the following statements are correct descriptions of structures P and Q?

P Q

A. Large number of air sacs and a large total Wall containing C-shaped rings of cartilage
surface area

B. Cells that secrete a surfactant Muscles that relax to form a domed shape

C. Muscles that relax to form a domed shape Cells that secrete a surfactant

D. Wall containing C-shaped rings of cartilage Large number of air sacs and a large total
surface area

Difficulty: EASY
D

Explanation‾Explanation:
Air enters the nasal cavity and then passes down the trachea (P). The trachea’s wall consists of C shaped rings of cartilage. Air
that passes down the trachea first enters the bronchi, then bronchioles and finally reaches the alveoli (Q). A characteristic of alveoli
is the presence of a large number of air sacs and the presence of cells that secrete a surfactant.

Choice A is incorrect because the trachea does not contain a large number of air sacs; these air sacs are known as alveoli.

Choice B is incorrect because the trachea does not secrete a surfactant. However, it does secrete an immunoglobulin rich mucus.
Additionally, Muscles that contract and relax to form a dome are that of the diaphragm and not the alveoli.

Choice C is incorrect because the diaphragm, not the trachea, consists of muscles that relax to form a domed shape.

Question 12
CALCULATOR

Ventilation is important in maintaining the concentration gradients of oxygen and carbon dioxide between the air in the alveoli and
blood flowing in adjacent capillaries.

Which of the following shows the correct concentration gradients when the diffusion of gases is taking place?
 Diffusion of oxygen into the blood Diffusion of carbon dioxide into the alveoli

A. Higher oxygen concentration in alveoli Lower carbon dioxide concentration in the alveoli

B. Higher oxygen concentration in alveoli Lower carbon dioxide concentration in the blood

C. Lower oxygen concentration in the blood Higher carbon dioxide concentration in the alveoli

D. Lower oxygen concentration in the alveoli Higher carbon dioxide concentration in the blood

Difficulty: EASY
A

Explanation‾Explanation:
For oxygen to diffuse into the blood, there must be a higher concentration of oxygen in the alveoli than in the blood (Choice D).
This is because gases only diffuse down their concentration gradients.

Similarly, for carbon dioxide to diffuse into the alveoli, there should be a lower concentration of carbon dioxide in the alveoli (Choice
C) and a higher concentration of carbon dioxide in the blood (Choice B).

Question 13
CALCULATOR

Which method(s) could be used to measure ventilation rate?

I. Strap a belt around the chest and measure the pressure from the contraction and expansion of the
chest using a data logger.

II. Breathe into a mouthpiece connected to a spirometer and measure the volume of air inhaled and
exhaled over a period of time.

III. Place hands on the chest and count the number of times the chest rises over a period of time.

● A. I only

● B. III only

● C. I and II only

● D. I, II and III

Difficulty: EASY
D

Explanation‾Explanation:
Choice D is correct because the ventilation rate can be measured using a chest belt and pressure monitor connected to a data
logger (Statement I). The pressure monitor would show the pressure based on the contraction and expansion of the chest.
Ventilation rate can also be measured using a spirometer which would show the volume of air inhaled and exhaled when breathing
is done through a mouthpiece connected to the spirometer (Statement II). Ventilation rate can also be measured in a simple way by
observing and counting the number of times the chest rises over a period of time, for instance, 1 minute (Statement III).
Choice A is incorrect because it is missing statements II and III.
Choice B is incorrect because it is missing statements I and II.
Choice C is incorrect because it is missing statement III.

Question 14
CALCULATOR

[Maximum mark: 6]

The diagram shows an apparatus used to investigate the rate of transpiration in plants.

[Source: Adapted from Knott, T. (2006, August). File: Potometer.png. Wikimedia commons. Retrieved May 3, 2023, from
https://commons.wikimedia.org/wiki/File: Potometer.png. CC-BY-SA-3.0-migrated]

1. Name this piece of apparatus. [1]

2. Describe the relationship between rate of transpiration and the movement of the bubble. [1]

This table shows data collected by a student when they used the piece of apparatus in (a) to investigate the effect of temperature
on the rate of photosynthesis.

1. Describe, using the data provided, the relationship between temperature and the rate of water uptake. [1]

2. Explain the change in water uptake from 20 ⁰C to 35 ⁰C. [2]

3. Suggest a reason for the lower rate of transpiration at 40 ⁰C. [1]

Difficulty: MEDIUM
Question 15
CALCULATOR

[Maximum mark: 7]

1. Describe the structure of the bronchioles. [2]

2. Distinguish between the external intercostal muscles and the internal intercostal muscles. [2]

3. Outline how the concentration gradients of oxygen and carbon dioxide are maintained in the lungs. [3]

Difficulty: MEDIUM
Question 16
CALCULATOR

What is the main factor that causes the pressure inside xylem vessels to be lower than atmospheric pressure?

● A. Cohesive properties of water inside xylem vessels

● B. Evaporation of water during transpiration

● C. Water molecules sticking to the walls of xylem vessels

● D. Exchange of oxygen and carbon dioxide through the stomata

Difficulty: MEDIUM
B

Explanation‾Explanation:
Water loss by evaporation due to transpiration in leaves causes the pressure inside xylem vessels to be lower than atmospheric
pressure.

The cohesive properties of water do not significantly affect the pressure in xylem vessels (Choice A). They allow for the water
column to move upwards in the stem.

Water molecules sticking to the walls of xylem vessels is due to the adhesive properties of water. This does not significantly
contribute to the low pressure inside the xylem (Choice C). Adhesive properties, together with cohesive properties, are responsible
for capillary action.

The exchange of oxygen and carbon dioxide through stomata does not affect the overall pressure in xylem vessels (Choice D).
However, the diffusion of water out of the stomata does contribute to decreasing the pressure in xylem vessels.

Question 17
CALCULATOR

[Maximum mark: 10]

A group of students were asked to design an experiment to test the effect of the number of leaves on transpiration rates in plant
shoots.

Students took cuttings of shoots with different numbers of leaves from the same plant and placed the stems in a simplified
potometer.

Each of the stems was placed by a window, and the water level was recorded every day for 3 days.

[© Revision Village 2022. Created with Chemix (https://chemix.org)]

The results are shown in the table.

 1. State clearly which is the dependent variable and independent variable in this investigation. [2]

2. Identify the two days between which the plant shoots lost the greatest volume of water. Suggest a reason for this. [2]

3. Calculate, as a percentage, the total water lost from the plant shoot with two leaves by day 3. [1]

1. Suggest a reason for the similarity in results between the plant shoot with two leaves and three leaves. [1]

2. Based on the results of the plant shoot with one leaf and assuming all other factors were controlled, predict the
volume of water left in the graduated cylinder on day 2 for a plant shoot with 5 leaves. [1]

3. Suggest a way in which the students could improve the reliability of their experiment. [1]

4. Evaluate the use of the students' methodology in testing the effect of the number of leaves on the transpiration
rate of plant shoots. [2]

Difficulty: MEDIUM
Question 18
CALCULATOR

[Maximum mark: 15]

Strawberries are a popular fruit sold around the world. However, despite their popularity, their retail value, like many other fruits, is
based on their quality, which can be negatively impacted by factors which affect them before and after harvest.

A study was conducted which looked at the factors behind two common conditions in strawberries, water soaking and shrivelling,
both of which can have severe impacts on the quality of fruits.

The graphs below show the result of an experiment which investigated the rate of water uptake by strawberries before harvest and
the rate of transpiration after harvest in relation to the surface area of the fruit.
[Source: Adapted from Hurtado G, Grimm E, Brüggenwirth M, Knoche M (2021). Strawberry fruit skins are far more permeable to
osmotic water uptake than to transpirational water loss. PLoS ONE 16(5). Retrieved November, 2022, from
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251351. Copyright- free]

1. Compare and contrast the rates of water uptake and transpiration in strawberries. [2]

2. Suggest a reason for the discrepancy between the rate of water uptake and the rate of transpiration. [1]

2. Calculate the surface area (cm

2
) which would result in the uptake of 500 mg of water in two hours. [1]

3. State the tissue through which water is transported in plants. [1]

In an attempt to reduce the volume of water uptake in strawberries, scientists tested the effect of incubating them in different
isotonic solutions, which contained solutes of varying molecular weights. The results of the experiment are shown below.

[Source: Adapted from Hurtado G, Grimm E, Brüggenwirth M, Knoche M (2021). Strawberry fruit skins are far more permeable to
osmotic water uptake than to transpirational water loss. PLoS ONE 16(5). Retrieved November, 2022, from
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251351. Copyright- free]

4. State the term used to describe the movement of water molecules into and out of plant cells. [1]

1. Identify the incubation solution which resulted in the lowest uptake of water in strawberries. [1]

2. Describe the relationship between water uptake and the molecular mass of solutes in the incubation solution.
[1]

3. Predict the uptake for strawberries incubated in a solution containing PEG6000 if they were incubated for 2 hours.
[1]

Despite the influence of environmental factors on the quality of strawberries before and after harvest, genetic factors were also
attributed to important retail characteristics, such as the colour of strawberries.

In the experiment below, 40 Redlands Joy strawberry plants were pollinated in the following four ways:
 ● Autogamy (natural pollination with pollen from the same flower)
● Self (hand pollinated with pollen from the same plant)
● Sugarbaby (hand pollinated with pollen from the sugarbaby variety)
● Rubygem (hand pollinated with pollen from the Rubygem variety)

The brightness, redness and yellowness of the fruits produced from each plant was recorded.

[Source: Adapted from Dung CD, Wallace HM, Bai SH, Ogbourne SM, Trueman SJ (2021) Cross-pollination affects fruit colour,
acidity, firmness and shelf life of self-compatible strawberry. PLoS ONE 16(9). Retrieved November, 2022 from
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0256964. Copyright-free]

6. Calculate as a percentage, to the nearest whole number, how much brighter the brightest strawberries were, compared to
the dullest strawberries. [1]

7. Describe the effect of different pollination treatments on the colour of strawberries. [3]

8. Discuss whether the data provided supports the hypothesis that cross-pollinated strawberry flowers produce strawberries
with a higher retail value than self-pollinated strawberry flowers. [2]

Difficulty: MEDIUM
Question 19
CALCULATOR

The image below compares the mortality rate for smokers and non-smokers over the age of 40.
[© Revision Village 2022]

Based on the graph above, which statement is correct?

● A. Smoking is the cause of early death.

● B. More smokers survive at the age of 90.

● C. A smoker and a non-smoker have the same chances of survival at the age of 70.

● D. After 60 years old, more non-smokers survive compared to smokers.

Difficulty: MEDIUM
D

Explanation‾Explanation:
Choices A is incorrect because we cannot be sure what is the cause of death. Correlation does not mean causation.

Choice B is incorrect because the graph only extends to 80 years old.

Choice C is incorrect because the graph shows more mortality in smokers at the age of 70.

Choice D - The graph shows that the survival of non-smokers is consistently higher than that of smokers.

Question 20
CALCULATOR

How can tobacco smoke cause breathing difficulties in smokers?

● A. It reduces the amount of mucus in the lungs.

● B. It decreases the concentration of carbon monoxide in the blood.

● C. It leads to an increase in the surface area of the lungs.

● D. It increases the size of the alveoli.

Difficulty: MEDIUM
D

Explanation‾Explanation:
Tobacco smoke contains harmful chemicals that break down the walls of the alveoli causing them to enlarge. The increase in the
size of the alveoli leads to a decrease in the gas-exchange surface area (Choice C) which makes breathing more difficult for
smokers.

Tobacco smoke increases the amount of mucus produced in the lungs causing frequent coughing and sputum (Choice A).

Tobacco smoke will increase the concentration of carbon monoxide in the blood as CO is produced in the burning of cigarettes
(Choice B).

Question 21
CALCULATOR

[Maximum mark: 16]

Gas exchange is very important for both plants and animals.

1. Outline the properties of gas-exchange surfaces. [4]

2. Describe how muscles bring about pressure changes during inspiration in humans. [4]

3. Transpiration is a result of gas exchange in plants. Explain how different environmental factors affect the rate of
transpiration. [7]

Difficulty: MEDIUM
Question 22
CALCULATOR

[Maximum mark: 10]

Lung volumes and ventilation rates can be measured using a spirometer. During a school lab a student was asked to breathe
normally at rest, then they were asked to take the deepest breath in that they could, followed by the largest breath out, before
returning to breathing normally at rest. Below is the trace for this student.

[© Revision Village 2023]

 1. Calculate the total volume of air inhaled and exhaled during one minute by this student when breathing normally at rest.
[2]

Below is a diagram of the spirometer used by the students. The subject puts on a nose clip, to prevent air from escaping through
the nose, and breathes in and out through the mouthpiece. The chamber is closed so the volume of air with each inhalation and
exhalation can be recorded on the drum trace. The chamber is opened between trials to allow the air to refresh and the trace to be
recalibrated.

[© Revision Village 2023]

2. Explain why the trace decreased in height during the 100 seconds. [2]

3. Suggest a possible investigation that could be conducted using the spirometer. [2]

4. State two variables that must be controlled in the investigation you suggested in part (c). [2]

Another student, who played the flute regularly, was then asked to record their results to compare them to student 1, who did not
play a wind instrument. The trace for this second student is shown below.

[© Revision Village 2023]

5. Discuss whether the data in the two graphs support the hypothesis that playing a wind instrument increases lung volume.
[2]

Difficulty: MEDIUM
Question 23
CALCULATOR

A spirometer is an apparatus that measures the volume of air (dm33) inhaled and exhaled over a period of time. The graph below
shows the spirometer reading of an individual after exercise.
[ © Revision Village 2022]

What would the spirometer reading look like for an individual at rest who has not recently exercised compared to the reading shown
above?

● A. Tidal volume would be higher

● B. Volume of air inhaled per breath would be the same

● C. Decrease in ventilation rate

● D. Graph would appear linear without fluctuations

Difficulty: MEDIUM
C

Explanation‾Explanation:
After mild or vigorous exercise spirometer readings show a higher ventilation rate with a higher number of breaths per minute and a
larger amplitude. While at rest, the rate of ventilation would be comparatively less (Choice C).

Tidal volume, which is the volume of air that is inhaled or exhaled per breath, would be lower while at rest (Choices A and B).

The graph would not be linear while at rest because air would still be inhaled and exhaled unless a person was holding their breath.
The volume would increase, showing an upward slope during inhalation and would then decrease during exhalation, showing a
downward slope (Choice D).

Question 24
CALCULATOR

[Maximum mark: 16]

1. Draw a plan to show the distribution of different tissues in a transverse section of a dicotyledonous plant stem. [3]
 2. Describe the movement of water in plants beginning with water in the soil and ending with water vapour in the atmosphere.
[5]

3. Explain how different environmental factors affect the rate of transpiration. [7]

Difficulty: HARD
Question 25
CALCULATOR

The photograph below shows lungs that have undergone excessive breakdown of alveoli by protein-digesting enzymes (part on the
left) compared to normal lung tissue (on the right).
[Source: Rosen, Y. (2010, August). File: Bullous emphysema (4858473626).jpg. Wikimedia commons. Retrieved Jun 8, 2022, from
https ://commons.wikimedia.org/wiki/File: Bullous_emphysema_%284858473626%29.jpg Copyright under CC-BY-SA-2.0]

Which of the following are not symptoms of the lung condition pictured above?

● A. Coughing up blood

● B. Fatigue

● C. Shortness of breath

● D. Persistent cough

Difficulty: HARD
A

Explanation‾Explanation:
The lung condition in the diagram belongs to a patient with emphysema. The possible symptoms are fatigue (Choice B), shortness
of breath (Choice C), and a persistent cough (Choice D).

Coughing up blood is a consequence of lung cancer.

Question 26
CALCULATOR

During ventilation, air from the atmosphere enters the lungs. Lungs consist of alveoli which lack muscular tissue. The lungs are
attached to the ribcage through the pleural membranes which are filled with a fluid with a constant volume.

What would be the most likely consequence if there was a puncture in the ribcage exposing the lungs?

● A. Walls of the trachea would stick together

 ● B. Intercostal muscles and diaphragm would not function

● C. Pressure inside the thorax would be similar to atmospheric pressure

● D. Uncontrolled cell division in the lungs resulting in a tumour

Difficulty: HARD
C

Explanation‾Explanation:
The inner pleural membrane covers the surface of the lungs, the outer membrane lines the inner surface of the ribs and diaphragm.
Pleural fluid between the membranes acts as a lubricant and also helps to adhere the two membranes together through surface
tension. However, the key factor that holds the two membranes together is the negative intrapleural pressure inside the thorax. The
pressure between the two membranes is lower than atmospheric and alveolar pressure, thereby holding the membranes in close
contact. The low pressure and surface tension allow the lungs to remain attached to the chest wall, facilitating lung expansion
during inhalation.

If these pleural membranes were punctured pleural fluid would be able to get out and air would get in. The pressure inside the
thorax would become similar to the atmospheric pressure, and the pleural membranes would no longer adhere to each other
leading to lung collapse. Choice C is therefore correct.

The walls of the trachea cannot stick together under any circumstances as they contain cartilaginous rings which keep them open
(Choice A).

Most of the external and internal intercostal muscles and the diaphragm can work regardless of a puncture injury to the ribcage
(Choice B).

Uncontrolled cell division which causes tumours is usually caused by carcinogens, not by the physical injury (Choice D).